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Wed July 10, 2013
Will Missouri ever play nice with Obamacare?
This week guest host Harum Helmy explains all the ways Missouri is mucking up the implementation of "Obamacare."
Missouri's always had an independent streak. And when it comes to the implementation of ACA, President Obama's wide-ranging health care reform law, the state has put up a fight at every possible moment. Yes, multiple attempts to repeal the law have failed in Congress, but that doesn't mean that Missouri has to play nice with the law.
First, in the summer of 2012, came ACA's first major roadblock: a supreme court challenge. Onlookers largely paid attention to the so-called "individual mandate" which requires Americans to purchase some kind of insurance or face fines. That controversial part of the law was largely upheld in a tight 5-4 decision. But a different, important part of the law fell: Medicaid expansion.
Under ACA prior to the 2012 decision, each state would have bee required to expand the eligibility of Medicaid, growing the program dramatically. Big federal dollars would be available with the expectation that states would eventually start to pick up a portion of the bill. The 2012 decision made that part optional. About half of the states decided they would reject the federal money and leave their Medicaid programs just as they are. Missouri became one of those dissenting states and Governor Nixon has made it his (so far unsuccessful) mission to push Medicaid expansion through the legislature all year.
There's a second roadblock: ACA was supposed to require the creation of government-run online marketplaces for people to shop for insurance. States were encouraged to create these marketplaces themselves, but the Feds would step in if states failed to act. Not only did Missouri opt-out of this just as it did with Medicaid expansion, but it passed a ballot initiative that prevented state agencies from even helping with the creation of this marketplace. The strange result is that the federal government is now building this marketplace for us--along with the individual health plans its selling--and without state input whatsoever.
On this week's CoMo Explained podcast, we explain how this online marketplace is supposed to work. The marketplace should be ready by October 1, so get ready!
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Science, Health and Technology